Notes

Calcium supplements linking devices polysaccharide co-adsorption to a proxy marine surface microlayer.
Hemodialysis (HD) has a catabolic effect caused by alterations in protein metabolism, increase in resting energy expenditure (REE) and protein needs due to inflammation, HD circuit blood and heat losses, protein losses to dialysate and HD filter membrane biocompatibility. We aim to determine, as a proof of concept, whether a standardized intradialytic snack model is adequate to compensate the catabolic impact of HD.

Cross sectional analysis of patients' chosen intradialytic intake according to a snack model, at the day of blood sample collection of three different months. As targets for the compensation of the catabolic impact of HD, we considered 316.8kCal (1.32 (±0.18) kcal/min - 240' of HD) for the estimated increase in REE and at least 7g of protein losses/HD treatment.

A total of 448 meals were analyzed, with 383 given during daytime shifts. No intolerances were registered. The mean nutritional profile of the daytime shifts intakes was 378.8 (±151.4) kcal, 13.5 (±7.2) g of protein, 676 (±334) mg of sodium (Na), 361.0 (±240.3) mg of potassium (K) and 249.3 (±143.0) mg of phosphates (P). We found that 68% of the meals provided an intake ≥316.8kCal and 82% a protein intake ≥ 7g, with a significant association found between treatment shift and energy (p<0.028), protein (p<0.028), lipids (p<0.004), Na (p<0.004), K (p<0.009) and P (p<0.039) intakes.

We found that this intradialytic snack model meets the target for the treatment-related increases in protein and energy needs. Although sodium intake was found to be high, potassium and phosphate intake was considered adequate.
We found that this intradialytic snack model meets the target for the treatment-related increases in protein and energy needs. Although sodium intake was found to be high, potassium and phosphate intake was considered adequate.
Disorders of energy metabolism is a common phenomenon in cancer patients. Changes in resting energy expenditure (REE) combined with inadequate nutrition support appear to be causes of nutritional depletion in cancer patients. In clinical practice, REE is typically calculated using predictive equations. The aim of this study was to determine the agreement between REE estimated by predictive equations and REE measured by IC in Portuguese cancer patients. Differences in measured REE between patients with different types of digestive cancers were also assessed.

REE was measured by indirect calorimetry (IC) in 61 patients with cancer diagnosis (gastric cancer, cholangiocarcinoma, pancreatic cancer, liver cancer and colorectal cancer). Measured REE values were compared with those estimated by equations of Harris-Benedict, Schofield, Ireton-Jones, Mifflin-St.Jeor and Barcellos I and II.

Mean Respiratory Quotient (RQ) was 0.77±0.09, which indicates high lipids utilization as substrate. No statistically significts. Further research is needed to improve the current knowledge base of energy expenditure in cancer patients, and to improve the accuracy of existing predictive equations.
Although Barcellos Equations underestimate less and enable more accurate average REE prediction in cancer patients, still present wide limits of agreement and therefore clinically important differences in REE estimation may be found at individual level. Our results support the appropriateness of measuring REE by IC to better adequate the nutrition support to cancer patients. Further research is needed to improve the current knowledge base of energy expenditure in cancer patients, and to improve the accuracy of existing predictive equations.
Coronavirus disease 2019 (COVID-19) is an infectious disease that put unprecedented significant strain on clinical services and healthcare systems. The aim of the present research was to assess dietary food groups and also food habits of patients with clinical symptoms of COVID 19 and healthy controls.

This case-control research was carried out on 505 participants (279 subjects with clinical symptoms of COVID-19 and 226 controls), in age 18-65 years. Dietary food group's intake last year was investigated by a food frequency questionnaire. Food habits were asked by a general information questionnaire. The strength of the association between food group's intakes with the odds ratios (ORs) of COVID-19 was assessed using Logistic regression models.

After adjusting for physical activity in the logistic regression models, intake of dough and yogurt had a significantly protective role on occurrence of COVID19 (OR=0.62; 95% confidence interval (CI)=0.44-0.87; P=0.006) (OR=0.74; 95% CI=0.56-0.98; P=0.044), respectively. No significant differences were seen in food habits between the two groups in the last year ago.

High risk population for COVID19, advised to consume enough amount of yogurt and dough at the time of this pandemic.
High risk population for COVID19, advised to consume enough amount of yogurt and dough at the time of this pandemic.
Malnutrition is highly prevalent in patients with end-stage liver disease (ESLD) and associated with impaired clinical outcome. Previous studies focused on one component of body composition and not in combination with nutritional intake, while both are components of the nutritional status. We aimed to evaluate the most important risk factors regarding body composition (muscle mass, muscle quality and fat mass) and nutritional intake (energy and protein intake) for waiting list mortality in patients with ESLD awaiting liver transplantation (LTx).

Consecutive patients with ESLD listed for LTx between 2007 and 2014 were investigated. Muscle mass quantity (Skeletal Muscle Mass Index, SMI), and muscle quality (Muscle Attenuation, MA), and various body fat compartments were measured on computed tomography using SliceOmatic. Nutritional intake (e.g. energy and protein intake) was assessed. Multivariable stepwise forward Cox regression analysis was used for statistical analysis.

261 Patients (mean age 54 years, 74.7% male) were included. Low SMI and MA were found to be statistically significant predictors of an increased risk for waiting list mortality in patients with ESLD, with a HR of 2.580 (95%CI 1.055-6.308) and HR of 9.124 (95%CI 2.871-28.970), respectively. No association between percentage adipose tissue, and protein and energy intake with waiting list mortality was found in this study.

Both low muscle quantity and quality, and not nutritional intake, were independent risk factors for mortality in patients with ESLD.
Both low muscle quantity and quality, and not nutritional intake, were independent risk factors for mortality in patients with ESLD.
The European Society for Clinical Nutrition and Metabolism (ESPEN) proposed the ESPEN diagnostic criteria (EDC) for malnutrition in 2015. There is no report on the association between the EDC and prognosis in patients with gastrointestinal (GI) and hepatobiliary-pancreatic (HBP) cancer. This study aimed to (1) determine the prevalence of EDC malnutrition, (2) investigate the validity of the EDC as a nutritional and prognostic indicator, and (3) examine which components of the EDC are most related to long-term prognosis in patients with GI and HBP cancers.

A total of 634 patients with primary GI and HBP cancers who underwent their first resection surgery between July 2014 and March 2018 were retrospectively recruited. According to the EDC, patients were divided into malnourished and non-malnourished groups. Clinical parameters and survival between these two groups were compared. The prognostic effects of the EDC and the EDC components were analyzed using Cox proportional hazard models.

The prevalence of EDC malnutrition was 22%. LB-100 concentration Anthropometric data and biochemical data were associated with EDC malnutrition. The 5-year survival rate was lower in the malnourished group (72%) than in the non-malnourished group (73%; P=0.007). The multivariate analysis demonstrated that the malnourished group was an independent risk factor for mortality (hazard ratio=1.70 in the malnourished group; 95% confidence interval 1.08-2.63; P=0.024). Among EDC components, body mass index (BMI) of <18.5kg/m
was an independent poor prognostic factor.

EDC malnutrition is associated with poor postoperative long-term prognosis. Among the EDC components, BMI of <18.5kg/m
is most associated with prognosis in patients with preoperative GI and HBP cancers.
EDC malnutrition is associated with poor postoperative long-term prognosis. Among the EDC components, BMI of less then 18.5 kg/m2 is most associated with prognosis in patients with preoperative GI and HBP cancers.
A previous study have evaluated that antinuclear antibodies (ANA) negativization is linked to low lupus disease activity.

To describe a lupus patient who evolved with negativization of ANA, anti-dsDNA, and anti-chromatin antibodies after vitamin D supplementation.

Case report.

A 56-year-old female patient, diagnosed with systemic lupus erythematosus since 2015 characterized by typical malar erythema, photosensitivity, polyarthritis, leucopenia, positive antinuclear antibody, anti-dsDNA, and anti-chromatin antibody. She received hydroxychloroquine and prednisone. After 1 year, corticotherapy was tapered off, and no clinical evidence of lupus activity was registered (SLEDAI=0). However, ANA remained positive with a titer of 1640 with a homogeneous pattern, and positive anti-dsDNA 1/20 and anti-chromatin 97 Units (normal range <20 Units) remained all-time positive. Treatment with vitamin D 25,000 IU/day was initiated, and during follow-up, anti-chromatin and anti-dsDNA disappeared. In 2019, the patient was asymptomatic, keeping SLEDAI=0, negative anti-dsDNA and anti-chromatin, and surprisingly the ANA turned negative, which was confirmed on several occasions until now.

This case adds knowledge to the understanding that negative antinuclear antibodies appear to be associated with a better prognosis in lupus patients. Furthermore, the use of vitamin D seems to be a complementary therapeutic tool for this purpose.
This case adds knowledge to the understanding that negative antinuclear antibodies appear to be associated with a better prognosis in lupus patients. Furthermore, the use of vitamin D seems to be a complementary therapeutic tool for this purpose.
Vitamin D deficiency is an important complication of chronic intestinal failure (CIF). Liver steatosis is a known late complication of long-term home parenteral nutrition (HPN) therapy in patients with CIF, which can progress to intestinal failure-associated liver disease (IFALD). The aim of this study was to determine the prevalence of vitamin D deficiency among Slovene HPN patients and determine any potential correlation between serum vitamin D levels and liver steatosis associated with IFALD in adult patients with CIF on HPN therapy.

Adult patients, diagnosed with CIF, receiving long term HPN therapy, were included in a cross-sectional study. Vitamin D status was determined by measuring serum levels of 25-hydroxyvitamin D. The presence of liver steatosis was diagnosed using 3TS MRI scanner. The association between serum vitamin D levels and liver steatosis was calculated using univariate logistic regression.

We included 63 adult patients with CIF on HPN therapy in the study. The median duration of HPN therapy was 70 weeks.
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